Publication details
Dexamethasone treatment for COVID-19 is related to increased mortality in hematologic malignancy patients: results from the EPICOVIDEHA registry
| Authors | |
|---|---|
| Year of publication | 2024 |
| Type | Article in Periodical |
| Magazine / Source | Haematologica |
| MU Faculty or unit | |
| Citation | |
| web | https://haematologica.org/article/view/haematol.2023.284678 |
| Doi | https://doi.org/10.3324/haematol.2023.284678 |
| Keywords | COVID-19; Dexamethasone; hematologic malignancy patients |
| Description | The optimal treatment strategies for hematological malignancy patients with COVID19 are still unclear with respect to the selection and timing of anti-viral as well as anti-inflammatory therapies. Most COVID-19 management recommendations have been adapted from the ones used in immunocompetent patients However, immunosuppressed patients often have substantial alterations in their adaptive and innate immunity that affect the pathophysiology of SARS-CoV-2 infection and often have reduced anti-viral immunity as well as dysfunctional inflammatory response. As a result, we hypothesize that these patients mainly benefit more from antiviral treatment, whereas dexamethasone may perpetuate the intrinsic immunosuppression and be even detrimental. Our study demonstrates that dexamethasone treatment for SARS-CoV-2 infection is related to increased mortality in hematological malignancy patients, even during the omicron wave with most patients being fully vaccinated. Data included were exported from the EPICOVIDEHA registry (clinicaltrials gov. Identifier: NCT04733729). The corresponding local ethics committee of each participating institution has approved the EPICOVIDEHA study when applicable. The local Institutional Review Board and Ethics Committee of the Fondazione Policlinico Universitario Agostino Gemelli—IRCCS, Universita Cattolica del Sacro Cuore of Rome, Italy, approved the multicenter, non-interventional EPICOVIDEHA study (study ID: 3226). Both hospitalized and non-hospitalized patients were eligible for inclusion. Each patient was reviewed for validity following the inclusion criteria: i) patient >18 years old, ii) hematological malignancies with activity during the 5 years before COVID-19, iii) confirmed diagnosis for COVID-19 and iv) COVID-19 treatment information. Mortality rate was reported at 90 days after COVID-19 diagnosis. |